ALBUQUERQUE, N.M. — With the implementation of the Affordable Care Act, close to 27,000 Bernalillo County residents who rely on a UNM health care benefit program will have to go to Medicaid or the new insurance exchange for their insurance coverage.
UNM Care is a financial assistance program for uninsured Bernalillo County residents that cost University of New Mexico Hospital about $130 million last year.
New Mexico’s plan to expand Medicaid coverage is expected to absorb about 75 percent of patients now enrolled in UNM Care, estimated Rodney McNease, UNMH’s executive director of behavioral health finance.
Early this year, Gov. Susana Martinez announced that New Mexico would expand Medicaid coverage to an estimated 170,000 adults by 2020.
The remaining 25 percent of UNM Care patients are likely to qualify for insurance coverage that Americans can purchase through health insurance exchanges required by the Affordable Healthcare Act, McNease said.
UNMH has set a target of late March for moving UNM Care patients into Medicaid or an insurance plan, McNease said. The hospital is training personnel to help patients sign up for either during the six-month transition period, he said.
But UNMH also is prepared to extend the transition period if necessary to give patients time to sign up for the new plans, he said. “Our primary goal is to make sure that we don’t leave people without coverage,” McNease said.
The cost to UNMH of providing care to uninsured Bernalillo County residents enrolled in UNM Care grew substantially during the economic downturn.
A family of four with a household income up to $82,425 a year – 350 percent of the federal poverty level – could qualify for UNM Care. Its costs increased from $109 million in 2010 to $129.5 million in 2012, according to UNMH’s annual audit.
But the effect on UNMH’s finances of moving thousands of uninsured patients into insurance plans won’t become clear until patients begin signing up for coverage, McNease said.
“It’s really hard to predict right now until we see what the actual enrollments are” and how Medicaid and insurance plans pay for care for newly insured adults, he said.
On Tuesday, New Mexicans could begin signing up for expanded Medicaid coverage, though they are not eligible to begin receiving benefits until January.
Also Tuesday, New Mexicans could get access to the health insurance exchange by visiting www.bewellnm.com.
Primary funding for UNM Care comes from the Bernalillo County property tax levy, McNease said. The tax yielded $77.5 million in revenue for UNMH in 2012, according to the hospital’s audit.
UNMH also receives supplemental Medicaid payments because of its role as a safety-net hospital for indigent patients, he said. McNease had no estimate how much UNMH received from that source.
UNM Care is likely to survive as supplemental assistance to cover gaps in insurance plans, particularly for people who buy coverage through the health insurance exchange, McNease said. That supplemental coverage likely would cover copayments and deductibles required by insurance plans, he said.
“It’s quite probable that people will have out-of-pocket costs that are fairly significant,” he said. “Basically, the UNM Care would become like a supplemental assistance that would help bridge some of those gaps to help with the out-of-pocket costs.”
But the future of UNM Care will remain uncertain until New Mexicans begin signing up for coverage through Medicaid and the health insurance exchange, he said.
McNease had no estimate of how much UNM Care will cost after the transition period. Nor did he know specifically what UNM Care will cover in the future.
“Once we see the benefit packages from the plans – if there are gaps or significant shortfalls in that, that’s something we could revisit.”